Prostate cancer treatment has substantial effects on sexual health and function. Sexual function is a vital aspect of human health and a critical component of cancer survivorship, and understanding the potential effects of different treatment modalities on sexual health is crucial. Existing research has extensively described the effects of treatment on male erectile tissues necessary for heterosexual intercourse; however, evidence regarding their effects on sexual health and function in sexual and gender minority populations is minimal. These groups include sexual minority - gay and bisexual - men, and transgender women or trans feminine people in general. Such unique effects in these groups might include altered sexual function in relation to receptive anal and neovaginal intercourse and changes to patients' role-in-sex. Sexual dysfunctions following prostate cancer treatment affecting quality of life in sexual minority men include climacturia, anejaculation, decreased penile length, erectile dysfunction, and problematic receptive anal intercourse, including anodyspareunia and altered pleasurable sensation. Notably, clinical trials investigating sexual outcomes after prostate cancer treatment do not collect sexual orientation and gender identity demographic data or outcomes specific to members of these populations, which perpetuates the uncertainty regarding optimal management. Providing clinicians with a solid evidence base is essential to communicate recommendations and tailor interventions for sexual and gender minority patients with prostate cancer.
Nature reviews. Urology. 2023 May 22 [Epub ahead of print]
Daniel R Dickstein, Collin R Edwards, Eric J Lehrer, Elizabeth S Tarras, Matthew Gallitto, John Sfakianos, Matthew D Galsky, Richard Stock, Joshua D Safer, B R Simon Rosser, Deborah C Marshall
Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. ., Department of Radiology, Vagelos College of Physicians and Surgeons of Columbia University, New York, NY, USA., Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Department of Pulmonology, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, CT, USA., Department of Radiation Oncology, Vagelos College of Physicians and Surgeons of Columbia University, New York, NY, USA., Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Department of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Center for Transgender Medicine and Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Division of Epidemiology and Community Health, School of Public Health at University of Minnesota, Minneapolis, MN, USA.